Concussions a dangerous problem for high school athletes, too

Updated 1:09 pm, Thursday, May 24, 2012

Kelly's Will Darling is walked off the field after taking a nasty hit during the game against Nolan at Wildcat Stadium in Temple, Saturday, December 3, 2011. Tammy McKinley/The Enterprise

Kelly's Will Darling is walked off the field after taking a nasty hit during the game against Nolan at Wildcat Stadium in Temple, Saturday, December 3, 2011. Tammy McKinley/The Enterprise

Photo: TAMMY MCKINLEY

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Kelly's Will Darling is helped off the field after taking his second hard hit of the game against Nolan at Wildcat Stadium in Temple, Saturday, December 3, 2011. Tammy McKinley/The Enterprise

Kelly's Will Darling is helped off the field after taking his second hard hit of the game against Nolan at Wildcat Stadium in Temple, Saturday, December 3, 2011. Tammy McKinley/The Enterprise

Photo: TAMMY MCKINLEY

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After taking two hits to the head during a double header last year, Lumberton's Claire Arrington was made to sit out her entire junior season due to a concussion. Photo taken Wednesday, April 16, 2012 Guiseppe Barranco/The Enterprise

After taking two hits to the head during a double header last year, Lumberton's Claire Arrington was made to sit out her entire junior season due to a concussion. Photo taken Wednesday, April 16, 2012 Guiseppe

After taking two hits to the head during a double header last year, Lumberton's Claire Arrington was made to sit out her entire junior season due to a concussion. Photo taken Wednesday, April 16, 2012 Guiseppe Barranco/The Enterprise

After taking two hits to the head during a double header last year, Lumberton's Claire Arrington was made to sit out her entire junior season due to a concussion. Photo taken Wednesday, April 16, 2012 Guiseppe

After taking two hits to the head during a double header last year, Lumberton's Claire Arrington was made to sit out her junior season due to a concussion. Photo taken Wednesday, April 16, 2012 Guiseppe Barranco/The Enterprise

After taking two hits to the head during a double header last year, Lumberton's Claire Arrington was made to sit out her junior season due to a concussion. Photo taken Wednesday, April 16, 2012 Guiseppe

After taking two hits to the head during a double header last year, Lumberton's Claire Arrington was made to sit out her entire junior season due to a concussion. Photo taken Wednesday, April 16, 2012 Guiseppe Barranco/The Enterprise

After taking two hits to the head during a double header last year, Lumberton's Claire Arrington was made to sit out her entire junior season due to a concussion. Photo taken Wednesday, April 16, 2012 Guiseppe

Kelly's Brandtley Wilson kisses Will Darling on the head before Darling is taken to the hospital for a possible concussion at Wildcat Stadium in Temple, Saturday, December 3, 2011. Tammy McKinley/The Enterprise

Kelly's Brandtley Wilson kisses Will Darling on the head before Darling is taken to the hospital for a possible concussion at Wildcat Stadium in Temple, Saturday, December 3, 2011. Tammy McKinley/The Enterprise

Photo: TAMMY MCKINLEY

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Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, bottom, watches her computer screen as Adrain Webb, back, squats as the NeuroCom Balance Manager machine adjusts for his weight and movements Friday morning May, 18, 2012. The floor plate will move as well as the three sides of the box. Burns was preparing to use him in a demonstration on how Lamar athletes are tested for balance. The machine is capable of tilting, and moving the foot plate to different angles and the results are used as a baseline to assess balance before and after concussions. Webb was a student assistant for Deaf Studies and Deaf Education. Dave Ryan/The Enterprise

Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, bottom, checks the position of Adrain Webb's feet as she prepares to use him for a demonstration on how Lamar athletes are tested for balance. The machine, a NeuroCom Balance Manager, is capable of tilting and moving the foot plate and the results are used as a baseline to assess balance before and after concussions. Webb was a student assistant for Deaf Studies and Deaf Education. Dave Ryan/The Enterprise

Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, bottom, checks the position of Adrain Webb's feet as she prepares to use him for a demonstration on how Lamar athletes

Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, used Adrain Webb, a student assistant for Deaf Studies and Deaf Education as a stand in as she gave a demostration how the NeuroCom Balance Manager machine adjusts for his weight and movements Friday morning May, 18, 2012, as he stood on one foot. The floor plate will move as well as the three sides of the box. Burns used him in a demonstration on how Lamar athletes are tested for balance. The machine is capable of tilting, and moving the foot plate to different angles and the results are used as a baseline to assess balance before and after concussions. Dave Ryan/The Enterprise

Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, used Adrain Webb, a student assistant for Deaf Studies and Deaf Education as a stand in as she gave a demostration how

This is just a sample of the data that Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, is able to get using a NeuroCom Balance Manager machine, which is capable of tilting, and moving a foot plate to different angles and these results are used as a baseline to assess balance before and after concussions in athletes. Dave Ryan/The Enterprise

This is just a sample of the data that Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, is able to get using a NeuroCom Balance Manager machine, which is capable of

Adrain Webb's reaction of stepping backwards as the floor plate moved under him, is a typical reaction according to Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, as she prepared to use him for a demonstration on how Lamar athletes are tested for balance. The machine, a NeuroCom Balance Manager, is capable of tilting, and moving the foot plate to different angles and the results are used as a baseline to assess balance before and after concussions. Webb was a student assistant for Deaf Studies and Deaf Education. Dave Ryan/The Enterprise

Adrain Webb's reaction of stepping backwards as the floor plate moved under him, is a typical reaction according to Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, as

This is a side view of the machine tilting that Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, used as she prepared a demonstration on how Lamar athletes are tested for balance. The machine, a NeuroCom Balance Manager, is capable of tilting, and moving the foot plate to different angles and the results are used as a baseline to assess balance before and after concussions. Dave Ryan/The Enterprise

This is a side view of the machine tilting that Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, used as she prepared a demonstration on how Lamar athletes are tested

Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, bottom, watches Adrain Webb's reaction as the floor plate moved and he countered by sticking his arms out in front of him as she prepared to use him for a demonstration on how Lamar athletes are tested for balance. The machine, a NeuroCom Balance Manager, is capable of tilting, and moving the foot plate to different angles and the results are used as a baseline to assess balance before and after concussions. Webb was a student assistant for Deaf Studies and Deaf Education. Dave Ryan/The Enterprise

Erin Burns, Au.D.,CC-A, Staff Audiologist, Speech and Hearing Sciences at Lamar University, bottom, watches Adrain Webb's reaction as the floor plate moved and he countered by sticking his arms out in front of

Kelly High School quarterback, Will Darling, right, suffered two concussions last football season. He is now one of 50 Kelly football players to receive baseline concussion testing with the help of Athletic Trainer James Ashby, left. His scores will be used as a standard of measurement if he receives another concussion and needs to retake the test. Dave Ryan/The Enterprise

Kelly High School quarterback, Will Darling, right, suffered two concussions last football season. He is now one of 50 Kelly football players to receive baseline concussion testing with the help of Athletic

Kelly High School quarterback, Will Darling, left, suffered two concussions last football season. He is now one of 50 Kelly football players to receive baseline concussion testing with the help of Athletic Trainer James Ashby, right. On Friday, May 18, 2012, he was trying sections of the test again as a demostration. His scores will be used as a standard of measurement if he receives another concussion and needs to retake the test. Dave Ryan/The Enterprise

Kelly High School quarterback, Will Darling, left, suffered two concussions last football season. He is now one of 50 Kelly football players to receive baseline concussion testing with the help of Athletic

Kelly High School quarterback, Will Darling, suffered two concussions last football season. He is now one of 50 Kelly football players to receive baseline concussion testing with the help of Athletic Trainer James Ashby. On Friday, May 18, 2012, he was trying sections of the test again as a demostration. His scores will be used as a standard of measurement if he receives another concussion and needs to retake the test. Dave Ryan/The Enterprise

Kelly High School quarterback, Will Darling, suffered two concussions last football season. He is now one of 50 Kelly football players to receive baseline concussion testing with the help of Athletic Trainer

Kelly High School quarterback, Will Darling, suffered two concussions last football season. He is now one of 50 Kelly football players to receive baseline concussion testing with the help of Athletic Trainer James Ashby. On Friday, May 18, 2012, he was trying sections of the test again as a demostration. He got this question wrong. His scores will be used as a standard of measurement if he receives another concussion and needs to retake the test. Dave Ryan/The Enterprise

Kelly High School quarterback, Will Darling, suffered two concussions last football season. He is now one of 50 Kelly football players to receive baseline concussion testing with the help of Athletic Trainer

Kelly High School quarterback, Will Darling, suffered two concussions last football season. He is now one of 50 Kelly football players to receive baseline concussion testing with the help of Athletic Trainer James Ashby. On Friday, May 18, 2012, he was trying sections of the test again as a demostration. His scores will be used as a standard of measurement if he receives another concussion and needs to retake the test. Dave Ryan/The Enterprise

Kelly High School quarterback, Will Darling, suffered two concussions last football season. He is now one of 50 Kelly football players to receive baseline concussion testing with the help of Athletic Trainer

Lamar's Doug Prewitt carries the ball during the game against Stephen F. Austin at the Provost Umphrey Stadium at Lamar University in Beaumont, Saturday, November 5, 2011. Tammy McKinley/The Enterprise

Lamar's Doug Prewitt carries the ball during the game against Stephen F. Austin at the Provost Umphrey Stadium at Lamar University in Beaumont, Saturday, November 5, 2011. Tammy McKinley/The Enterprise

Photo: TAMMY MCKINLEY

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Doug Prewitt QB - Kelly HS - Beaumont, TX

Doug Prewitt QB - Kelly HS - Beaumont, TX

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Concussions a dangerous problem for high school athletes, too

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The last thing quarterback Will Darling remembered was holding the football.

He had no recollection of when his head crashed into the turf. The only thing he could recall was feeling dizzy and nauseous when he returned to his feet.

"I've been playing football since I was in sixth grade," the Kelly junior said. "And that was the hardest hit I've ever taken on the field."

Concussions are not only an issue in professional sports. The pros just get more of the limelight, especially now with nearly 2,200 former players suing the league, according to NFLConcussionLitigation.com.

Head injuries also are an issue for high school athletes, and not just in football. In fact, more than half of all concussions occur in sports other than football, according to a recent survey by the American Journal of Sports Medicine.

The University Interscholastic League, the governing body of public high school sports in Texas, requires concussed athletes to be cleared by a trainer or health-care professional before returning to play.

But not all concussions are clearly identified.

Several Southeast Texas schools are taking steps to better assess concussions and determine when an athlete safely can return to games.

"The old-school way, back when I first started, was if a player didn't lose consciousness and was symptom-free for 15 minutes, he was allowed to return to the game," said Vidor trainer David Shaw, whose first job was at Huntsville ISD in 1997. "Now if he has a concussion, even a suspected concussion, they're done. They're not coming back."

Darling's concussion, his second of the 2011 season, occurred when a defender tackled him from behind and drove his forehead into the turf. That came in the final minutes of the season-ending game, leaving Darling plenty of time to recover before baseball season started several weeks later.

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Lumberton soccer player Claire Arrington, however, can attest to the problems associated with returning to play too soon.

Arrington has no recollection of when her head collided with the knee of an opposing player during a match in January. She didn't know she had scored a goal until her coach told her.

"I remember holding the front of my head," the high school junior said. "It hurt so bad."

Unfortunately for Arrington, the worst was yet to come.

Another concussion followed hours later. Playing in a second game on that day, Arrington had her legs swept from under her, causing the back of her head to slam against the ground.

Arrington has not played in a game since, missing Lumberton's four-round playoff run. Persistent headaches and nausea limited her to half-day classes for close to two months after the hit.

Houston-based neuropsychologist Summer Ott said continuing to play and suffering a second traumatic hit to the head likely worsened Arrington's condition.

Arrington still gets headaches and carries a bottle of prescription ibuprofen at all times. Only recently did she resume full-team workouts during athletic periods.

"She has good days and bad days," said Arrington's mother, Karen.

The most severe concussions include memory loss.

That's what happened with former Lamar quarterback Doug Prewitt, who suffered his last concussion in a 2011 game at Nicholls State.

"I don't remember getting on the bus," Prewitt said.

His memory didn't clear until about two hours into a bus ride home from the game.

Dizziness, headaches and fatigue followed. His condition left him unable to lift weights for 10 weeks. He felt worse after this concussion than he had after any of his five previous ones. In March, one day before Lamar began spring practices, Prewitt told coaches he had decided to stop playing the sport.

His first concussion came playing football in the eighth grade, he said.

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Guidelines have changed drastically since Prewitt was in middle school.

Now, most athletes at Southeast Texas schools return only after they complete a series of tests that measure memorization and reaction time. These tests have proven to be more accurate indicators of concussion severity than common brain scans.

Scans such as the CT scan and MRI exams "can only show so much, like if there's bruising or bleeding in the brain," said third-year Ozen trainer Maggie Florez-Cook. "They do not show problems in the classroom and whatnot. That's what we need."

At some Southeast Texas schools, trainers have taken the additional step of doing exams before the season that rate memorization and response time, determining what is called a baseline score.

Then, if an athlete shows signs of a concussion, he or she will be tested again and have the new score compared to the baseline result. That athlete will not return to play until he or she scores near that baseline.

Athletes like 16-year-old Arrington, who did not have a pre-concussion baseline score, had her numbers compared to other female athletes her age who also have similar standardized test scores and grades. That comparison helped Ott, the neuropsychologist, determine Arrington's readiness to return to play.

Determining baseline scores requires honesty. The tests are given in secure, quiet locations. And scores are immediately reviewed for any alarming discrepancies, which could be an indicator that an athlete intentionally performed poorly to lower the standard he needs to meet to return to play.

But the large database from which to draw comparative scores can act as a safeguard against cheating the system, Ott and other trainers said.

Ott, who runs the Sports Concussion Program at the Ironman Sports Medicine Institute at Memorial Hermann Hospital in Houston, believes baseline testing will become more of a norm in coming years. Her testimony to the state Legislature in Austin last year helped establish more stringent return-to-play rules put in place before last football season.

Texas now is one of 31 states to have concussion-related state laws, according to a recent Associated Press report. The Texas law is commonly referred to as "Natasha's Law," named after soccer player Natasha Helmick of Allen, whose five concussions caused serious memory problems.

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Prewitt, the former Lamar quarterback, took one concussion assessment test called ImPACT with Ott after the last of his concussions and said it left him mentally exhausted.

One portion of the exam, taken at a desktop computer, flashes one set of words on the screen followed by another set of words, and asks the user to identify which words appeared in both sets.

Then, at the end of the exam, another set of words flashes on the screen, and the user must then identify which of those words were also included in the first set.

Other portions of the exam include color association and shape recognition tasks.

Scores are determined by measuring accuracy with response time.

"The answers might be slow, but if they got every one right, or if the times are fast and you missed a few here and there, that correlates too," Kelly trainer J.B. Ashby said. "It gives an overall number score and we look at what the average is and what the baseline is."

Darling took the test three times, first about a month after his second concussion, again before baseball season started in January and then again before spring football practices started last month.

The latest test will stand as Darling's baseline score for the coming football season.

"I realize there's a risk in everything," said Darling, who looks forward to playing his senior season. "In football, the risk is definitely there. It's part of the game."